Comparative Pharmacology
Head-to-head clinical analysis: AMANTADINE HYDROCHLORIDE versus CIDOFOVIR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AMANTADINE HYDROCHLORIDE versus CIDOFOVIR.
AMANTADINE HYDROCHLORIDE vs CIDOFOVIR
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Amantadine hydrochloride is an antiviral and antiparkinsonian agent. Its antiviral mechanism involves inhibition of the M2 ion channel of influenza A virus, preventing viral uncoating and replication. In Parkinson's disease, it increases dopamine release and inhibits dopamine reuptake, and also acts as an NMDA glutamate receptor antagonist, reducing excitotoxicity.
Cidofovir is a nucleotide analog that inhibits viral DNA polymerase by competing with deoxycytidine triphosphate for incorporation into viral DNA, resulting in chain termination and inhibition of viral replication.
For parkinsonism/drug-induced extrapyramidal symptoms: initial 100 mg twice daily; may increase to 300-400 mg/day in divided doses if needed. For influenza A treatment/prophylaxis in adults: 200 mg once daily or 100 mg twice daily; initiate prophylaxis as early as possible and continue for at least 10 days post-exposure.
5 mg/kg intravenously once weekly for 2 weeks, then 5 mg/kg every 2 weeks. Administer with probenecid 2 g orally 3 hours before dose, then 1 g at 2 and 8 hours after dose. Hydrate with 1 L normal saline before infusion.
None Documented
Clinical Note
moderateCidofovir + Teriflunomide
"The serum concentration of Teriflunomide can be increased when it is combined with Cidofovir."
Clinical Note
moderateTenofovir disoproxil + Cidofovir
"Tenofovir disoproxil may decrease the excretion rate of Cidofovir which could result in a higher serum level."
None Documented
Terminal elimination half-life: 10-14 hours in young adults; up to 34 hours in elderly (due to age-related decline in renal function); prolonged in renal impairment (up to 7 days in anuria).
Terminal elimination half-life is approximately 2.5 hours. However, the intracellular half-life of the active diphosphate metabolite is >48 hours, supporting once-weekly dosing.
Renal: 90% unchanged drug via glomerular filtration and tubular secretion; minor fecal (<5%) and biliary elimination.
Renal excretion of unchanged drug via glomerular filtration and tubular secretion accounts for approximately 90% of the administered dose. Biliary/fecal elimination is minimal (<5%).
Category C
Category D/X
Antiviral / Antiparkinsonian
Antiviral